When most offices monitor the dental hygiene department in their practice, they are somewhat aware of open time, cancellations, and no-shows. They may have an idea of how many there are, but not actually take the time to monitor how many they have in each category. Even if they do monitor the number of no-shows, cancellations and open time slots, they only do it on occasion and never really look at all the numbers at the end of the year.

If you take the time to monitor your hygiene department and actually look at the negative units at the end of the year, you may realize there are too many hours of hygiene in the schedule to start with, your recall system may be broken, or patients need to be educated more about the importance of their hygiene appointment. One of the main reasons we do monitoring is to keep track of cancellations, no-shows, and open time. The other reason is to utilize them as checks and balances when it comes to posting.

Even though the front office will do treatment verification, they will still miss things, particularly if the back office forgets to write it down on the route slip and it was not in the appointment originally, or if it was originally in the appointment and they forgot to remove it. You do not want to miss posting the treatment to the patient’s ledger, but at the same time you do not want to make the mistake of charging for something that did not get done. If you did something and it is not in the ledger, it needs to be brought to the attention of the front office so they can add it to the patient’s treatment. This may be done in writing or verbally. You may want to make a note to yourself to go back in the ledger and confirm that the changes were made before the end of the month.

A hygiene monitor would consist of how many actual hours the hygienist is available for patient care. If there is a meeting or training, those are not counted in the hours available. Below are the definitions of “negative” time categories.

1. No-show: Patient does not call prior to the appointment and does not come in. 2. Cancellation: Patient called within a 24 hour period and cancelled their appointment. 3. Open time: Open for more than a 24 hour period.

The total negative time plus total treatment hours should equal the amount of time available for patient care. The hygienists should record what they do with each patient as it is being done, in order to accurately check the treatment posted to the ledger with the treatment that was actually done. This should be done as soon as possible, during open time in the hygiene schedule. This is not to accrue any additional hours.

The hygienist then totals the amounts charged for each patient. This is based on what is actually paid by insurance. The daily total should be based on what insurance pays, NOT the fee schedule. Once the monitors have been filled out for the entire month, they will be totaled and entered into a spreadsheet, listed month-to-month. Then at the end of the year, the total number of cancellations, no-shows, and open time will be evaluated.

If you do not have these numbers, you won’t know where to start with fixing your hygiene department. You will continue to make the same mistakes, and continue to have a lot of time unscheduled. A high number of no-shows and cancellations can be a sign that patients do not value their appointments, or your time. If this is where your problem is, you may want to look at working with your hygienist on verbiage and patient education. If you have a lot of open time, it may be a sign that there are weaknesses in your recall system, the practice has poor patient retention or you have too many hygiene hours.

Interested in improving your hygiene department? Email hygiene@mckenziemgmt.com and ask us about our 1-Day Hygiene Training Program or call 877-777-6151

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